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20 Cards in this Set
- Front
- Back
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What are possible etiologies of acute pericarditis? (7) |
- Infectious - Autoimmune - Post-MI - Drugs - Uremia - Radiation therapy - Malignancy |
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What are the symptoms of acute pericarditis? (6) |
- Sharp chest pains - positional pain - dyspnea - palpitations - cough - fever |
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What sign on physical exam is most indicative of acute pericarditis? |
Pericardial rub |
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What ECG findings may suggest acute pericarditis? |
- Sinus tachycardia - PR depression / diffuse ST elevation or PR elevation on aVR |
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What are the 4 phases of ECG change regarding acute pericarditis? |
1) PR elevation / ST elevation 2) Revert to normal 3) T-wave inversion 4) Revert to normal |
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What scan can detect inflammation of the pericardium? |
MRI with contrast |
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What is the treatment for acute pericarditis? (4) |
- Treat underlying cause - High dose aspirin / NSAIDs - Colchicine - Surgery |
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What is the treatment for idiopathic pericardial effusion? |
- Diuretics - Surgerical pericardial window or drain |
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What two etiologies for idiopathic pericardial effusion are not seen in acute pericarditis? |
- Hypo/hyperthyroidism - Amyloidosis |
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How does cardiac tamponade differ from pericardial effusion? |
Rate of increase in fluid in pericardial space |
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What is Beck's triad? |
Signs of cardiac tamponade: - Distended neck veins - Hypotension - Distant heart sounds |
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How is pulsus paradoxus detected? |
Using manual blood pressure cuff, slowly lower pressure until systole disappears or becomes quieter during inspiration
(only record systole when it does not disappear) |
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What chambers of the heart are first to increase in pressure during cardiac tamponade? |
RA and RV |
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To what pressure do the right and left atrium rise during cardiac tamponade? |
20 mmHg |
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What will an echocardiogram of a cardiac tamponade show? (6) |
- Pericardial effusion - Right atrial collapse - RV diastolic collapse - Dilated and fixed IVC - Tricupsid changes during inspiration - Mitral changes during expiration |
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What is the treatment for cardiac tamponade? (2) |
- IV fluids - Pericardiocentesis |
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What is constrictive pericarditis? |
Pericardium inflames and adheres tightly to the epicardium of the heart leading to increased diastolic pressure |
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With constrictive pericarditis, what occurs during inspiration? |
The RV interventricular septum bulges into the LV |
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With constrictive pericarditis, what occurs during expiration? |
The LV interventricular septum bulges into the RV |
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What is the treatment for constrictive pericarditis?
What nerve needs to be avoided during this procedure? |
- Pericardial stripping / Pericardiectomy
- phrenic nerve |
